Congestive heart failure disease management in Medicare-managed care

• Published in: The American heart journal 2007-12, Vol.154 (6), p.1153-1159
• Main Authors: Mehrotra, Ateev, MD, MPH, McNeil, Barbara J., MD, PhD, Landon, Bruce E., MD, MBA
• Format: Article
• Language: English
• Subjects: Asthma; Biological and medical sciences; Blood pressure; Cardiology. Vascular system; Cardiovascular; Cardiovascular disease; Case management; Cost Savings; Diabetes; Disease Management; Health Care Surveys; Heart; Heart failure; Heart Failure - therapy; Heart failure, cardiogenic pulmonary edema, cardiac enlargement; Hospitals; Humans; Managed care; Managed Care Programs - organization & administration; Managed Care Programs - statistics & numerical data; Medical sciences; Medicare; Patients; Primary care; Quality of Health Care; United States
• ISSN: 0002-8703; 1097-6744
• DOI: 10.1016/j.ahj.2007.07.024

Background In 2001, the Center for Medicare and Medicaid Services began 2 initiatives that encouraged Medicare-managed care plans to introduce congestive heart failure (CHF) disease management programs. Our study was designed to describe the use, structure, and content of these programs. Methods In 2003 to 2004, we invited the representatives of Medicare-managed care plans with ≥750 enrollees to participate in a survey by mail or telephone. Results Representatives of 120 plans, 84 (70%) responded. Of the plans, 92% had CHF programs, 45% of which were instituted in 2001 or later, and 42% of which were handled externally by commercial vendors. Vendor use was more common in large programs (>30 000 Medicare enrollees) than in small programs (